To analyze the preoperative ultrasonographic characteristics and risk factors for postoperative recurrence of papillary thyroid carcinoma (PTC) .

A total of 320 patients with thyroid papillary carcinoma admitted to Xuanwu Hospital from January 2015 to December 2018 were selected. According to follow-up results, the patients were divided into either a recurrence group (n=292) or a non-recurrence group (n=28). Data including gender, age, tumor composition, ultrasound characteristics (echo, boundary, morphology, microcalcification, long-to-short dimension ratio, TI-RADS 4a-4b, and TI-RADS 4c-5), and pathological features (size of lesion, multifocal lesions, extra-membranous invasion, cervical lymph node metastasis, and surgical methods) were recorded. The risk factors for postoperative recurrence were identified, and the correlation between postoperative recurrence of thyroid papillary carcinoma and preoperative ultrasonic characteristics was analyzed.

Among the 320 patients included, 28 (8.75%) had recurrence. Univariate analysis showed that TI-RADS 4c-5, tumor cystic degeneration, tumor boundary, long-to-short dimension ratio, tumor size, cervical lymph node metastasis, and surgical method were risk factors for PTC recurrence (P<0.001, <0.001, =0.002, =0.006, =0.003, <0.001, and =0.035, respectively). Multivariate Cox proportional risk analysis demonstrated that TI-RADS 4c-5 (P=0.009), tumor cystic degeneration (P<0.001), tumor size (P=0.001), and cervical lymph node metastasis (P=0.005) were independent risk factors for recurrence.

More malignant ultrasound features of PTC suggest a greater possibility of recurrence. TI-RADs 4c-5 is an independent risk factor for recurrence in PTC patients. Cystic degeneration, tumor size, and cervical lymph node metastasis are predictive factors for PTC recurrence.